Disfunción Sexual Masculina

Presentación del tema: "Disfunción Sexual Masculina"— Transcripción de la presentación:

1 Disfunción Sexual Masculina
Dr. Christian Mauro Stamati

2 Objetivos Conocer las diferentes entidades reconocidas como disfunción sexual masculina. Cómo abordar la disfunción sexual.

3 Fases de la respuesta sexual masculina
Líbido. Erección. Eyaculación. Orgasmo. Latencia.

4 Fases de la respuesta sexual masculina
Líbido. Erección. Eyaculación. Orgasmo. Latencia.

5 Líbido disminuída o abolida
Hipoandrogenismo Psicógeno Drogas Agonistas LH Rh Testosterona baja Depresión Antiandrógenos Prolactina Ansiedad Antipsicóticos Hipergonadotrófico Hipogonadotrófico Benzodiacepinas FSH LH FSH LH Finasteride Hum Psychopharmacol Apr;23(3): Links Sexual dysfunction in schizophrenia: focus on recent evidence. Baggaley M. South London & Maudsley NHS Foundation Trust Clinical Director, Sex & Relationship Problems Clinic, York Clinic, Guy's Hospital, London, UK. BACKGROUND: Antipsychotic medications are known to be commonly associated with sexual dysfunction. Sexual dysfunction is estimated to affect 30-80% of patients with schizophrenia and is a major cause of poor quality of life. However, few comparative studies on the sexual dysfunction effects associated with antipsychotic medication have been published and the effects of the newer atypical antipsychotics have been largely unexamined. OBJECTIVE: This review aims to examine the latest evidence regarding the sexual function effects of different antipsychotic medications, particularly the newer prolactin-sparing drugs, quetiapine and aripiprazole, in patients with schizophrenia and schizoaffective psychosis. METHODS: A literature search was conducted within PubMed/MEDLINE using the terms risperidone, haloperidol, clozapine, olanzapine, ziprasidone, quetiapine, aripiprazole; sexual dysfunction; schizophrenia. The results were limited to studies published since RESULTS: Recently published studies show that the relative impact of antipsychotics on sexual dysfunction can be summarised as risperidone > typical antipsychotics (haloperidol) > olanzapine > quetiapine > aripiprazole. CONCLUSIONS: The availability of prolactin-sparing antipsychotics should enable psychiatrists to consider and manage proactively the sexual function consequences of pharmacological intervention, thereby improving sexual side effects, which may lead to improved treatment adherence and psychiatric outcome in patients with schizophrenia John Wiley & Sons, Ltd. Alcohol Psiquiatría Testículo Hipófisis Urología Endocrinología Hiperprolactinemia

6 Líbido Amentada Hormonal Psicógeno Drogas Dietiletilbestrol Cocaína
Adenoma Suprarrenal Pubertad Hiperfunción Suprarrenal Cocaína Cáncer Suprarrenal Tumor Células Sertoli Testosterona Tumor pancreático endocrino Hum Psychopharmacol Apr;23(3): Links Sexual dysfunction in schizophrenia: focus on recent evidence. Baggaley M. South London & Maudsley NHS Foundation Trust Clinical Director, Sex & Relationship Problems Clinic, York Clinic, Guy's Hospital, London, UK. BACKGROUND: Antipsychotic medications are known to be commonly associated with sexual dysfunction. Sexual dysfunction is estimated to affect 30-80% of patients with schizophrenia and is a major cause of poor quality of life. However, few comparative studies on the sexual dysfunction effects associated with antipsychotic medication have been published and the effects of the newer atypical antipsychotics have been largely unexamined. OBJECTIVE: This review aims to examine the latest evidence regarding the sexual function effects of different antipsychotic medications, particularly the newer prolactin-sparing drugs, quetiapine and aripiprazole, in patients with schizophrenia and schizoaffective psychosis. METHODS: A literature search was conducted within PubMed/MEDLINE using the terms risperidone, haloperidol, clozapine, olanzapine, ziprasidone, quetiapine, aripiprazole; sexual dysfunction; schizophrenia. The results were limited to studies published since RESULTS: Recently published studies show that the relative impact of antipsychotics on sexual dysfunction can be summarised as risperidone > typical antipsychotics (haloperidol) > olanzapine > quetiapine > aripiprazole. CONCLUSIONS: The availability of prolactin-sparing antipsychotics should enable psychiatrists to consider and manage proactively the sexual function consequences of pharmacological intervention, thereby improving sexual side effects, which may lead to improved treatment adherence and psychiatric outcome in patients with schizophrenia John Wiley & Sons, Ltd.

7 Fases de la respuesta sexual masculina
Líbido. Erección. Eyaculación. Orgasmo. Latencia.

8 Trastornos de Erección
Hormonal Vascular Disfunción Eréctil Neurológica Psicógena Drogas Idiopático Priapismo Leucemia Drogas

9 Fases de la respuesta sexual masculina
Líbido. Erección. Eyaculación. Orgasmo. Latencia.

10 Trastornos de eyaculación
Eyaculación Precoz Eyacualción Retardada Ausencia o pérdida del control eyaculatorio Psicógena Neurológica Drogas Primaria Secundaria Terapia conductual Estimulación vibratoria Terapia conductual (pareja) Medicación ? Ejercicios estímulo-parar Medicación Inhibidores de recaptura de serotonina

11 Fases de la respuesta sexual masculina
Líbido. Erección. Eyaculación. Orgasmo. Latencia.

12 Trastornos del orgasmo
Doloroso No placentero Prostatitis Prostatitis Disfunción piso pélvico Diabetes Neurológico Psicógeno

13 Fases de la respuesta sexual masculina
Líbido. Erección. Eyaculación. Orgasmo. Latencia.

14 Disfunción Sexual Masculina
Cómo abordarlas ? Evite prejuicios Si no sabe o no le interesa manejar el caso refiéralo inmediatamente Determine exactamente cuál es el problema ? Sea claro con el paciente desde la primera cita Tenga un plan de manejo En ocasiones no existe respuesta correcta

15 Relación Sexual Normal
Debe producir placer Cada quien es responsable de su propio placer Todo está bien si ninguno se siente afectado, obligado o culpable

16 Disfunción exual Masculina